Dr. Ezekiel Emanuel, UPenn Vice Provost of Global Initiatives, Former White House Health Policy Adviser, and author of ‘Which Country Has the World’s Best Health Care?’, joined The Final Round to discuss President Trump receiving the Regeneron treatment for COVID-19, how his administration has been handling the virus, and his thoughts on states reopening for indoor dining and activities.
SEANA SMITH: President Trump’s physician saying that he is feeling much better and can safely return to public events this Saturday, which would be 10 days from when we know about his symptoms. But the president is said to be planning an in-person event Saturday at the White House.
For a little bit more on this, we want to bring in Dr. Zeke Emanuel. He’s the UPenn Vice Provost of Global Initiatives and also a former White House health policy advisor. Dr. Emanuel, it’s great to have you back on Yahoo Finance.
We know we don’t have a full picture with all the details regarding President Trump’s health and exactly where everything stands right now. But I’m curious, from your perspective, from what we do know, do you have any concerns at this point, public health concerns about President Trump either returning to the campaign trail or hosting some in-person event at the White House tomorrow?
EZEKIEL EMANUEL: Well, I always have concern because the president has flaunted the public health measures repeatedly. And so if he is going to return to public meetings with people– and 10 days is the CDC recommended timeline. But, you know, the question is, are we going to actually adhere to the public health measures?
He better wear a mask. There better be social distancing. And those interactions should be outside. And he should not be yelling or raising his voice, sneezing, coughing, and the other things that give you poor saturation and a lot of potential virus if he still has virus around.
So, you know, with those things in place, you know, those will be important checkpoints. I do worry that the president is planning big rallies with lots of people. And those rallies, in the past, have been not with social distancing, not with face masks. And that is extremely worrisome.
RICK NEWMAN: Hey, Dr. Zeke. Could you tell us your view on what is the appropriate amount of information the public should have about the president’s health, especially if he’s been through some kind of scare like this? Should we know everything, or might there be reasons that if he does have an ongoing problem, you wouldn’t want to broadcast it to the whole world, to the leaders of China and Russia and so forth?
EZEKIEL EMANUEL: Well, I do think we should know everything. And I do think the American public has a right to everything. You know, under previous presidents, certainly since President Reagan, we have had a very full disclosure of health conditions. And I think that ought to be the standard.
This president has never adhered to that standard in health and not adhered to that standard in terms of taxes. And both represent serious national security risks. And we need to know what’s happening. Let’s remember, no matter what happens November 3rd, the minimum amount of time this president’s in office is the next 3 and 1/2 months.
And the world is a very dangerous place, right? We’ve got China and the South China Sea and trade talks. We’ve got North Korea. We’ve got a conflict between Azerbaijan and Armenia. There are many, many flashpoints, and not to mention Iran.
We need to know that this president is actually doing well. We need to know that all of the factors that are influencing his health, his energy level, his ability to focus. And, you know, the flip-flop that we’ve just seen in the last few days on a stimulus, we’re calling off the stimulus.
Airlines, $1.8 trillion stimulus is what we have in mind. Oh, no, we need more. You know? That doesn’t instill confidence in anyone that he’s going to bring to bear good judgment on critical issues that might arise.
AKIKO FUJITA: Doctor, I wonder if you can speak to this political report that’s come out, talking about how the Pfizer CEO is courting some of its critics and those who have raised concerns about its timeline on the vaccine. Pfizer, of course, has said, potentially, they could know by the end of the month whether their vaccine is, in fact, effective.
And you’ve kind of been singled out in this article as somebody who has said that, look, there should be no authorization by the FDA until after the election. I’m curious what you make of Pfizer’s efforts and whether, in fact, you would feel comfortable at least meeting with the company, you know, what your concerns are at this point if, in fact, there is– one of these drug makers are looking to announce before the election, getting some kind of authorization.
EZEKIEL EMANUEL: Well, I had a call, actually, with the CEO of Pfizer today. And so I did discuss the situation with him. Let’s be clear. They could get a signal on effectiveness. But they won’t have a signal on safety that’s sufficient to go to the FDA for an emergency use authorization.
And I think, you know, we need both factors for an effective vaccine. Having an effective vaccine that isn’t safe is not a vaccine that you can use on healthy people. And so it seems to me that you have to have both factors before Pfizer goes to the FDA.
And as I understand it, you’re not going to have both factors until at least two weeks, maybe three weeks, after the election. You know, just having an effective vaccine is not sufficient and should not be the basis of anything. Public disclosure or certainly, an emergency use authorization, you have to have both effectiveness and safety. One alone is not of any value.
JEN ROGERS: Are you encouraged by the treatment that the president received and how well he seems to be doing, that the treatments actually work? Have we learned anything from the fact that he has had all this treatment and seems to be doing well?
EZEKIEL EMANUEL: No. You can’t learn anything from a case of one. We in medicine call it selection bias, right? You treat someone, and you’ve selected them on the basis of some factor.
And again, given the fact that we know so little about the president’s condition, when the last negative test is and when he actually got the first test that turned out to be positive, what his actual condition was when they drew– you know, now we know that they drew labs looking for antibodies on Thursday. That suggests that they knew ahead of Thursday that he was COVID positive.
And when did they know? What symptoms was he displaying? Why did they draw the antibody levels? As we understand, the antibody levels were low. That’s actually not a good sign. And that was the reason for getting the Regeneron antibody cocktail.
If he isn’t unique in getting the Regeneron cocktail, then Remdesivir, then dexamethasone, he’s certainly in a very tiny group. And it’s very hard to draw any conclusion on that basis. That’s why we do research. That’s why we actually include patients. We do randomized trials.
That he didn’t get the Regeneron on a randomized trial, I think it’s wrong and unethical. If he was going to get Regeneron, it should have been like everyone else on a clinical trial.
SEANA SMITH: Well, Dr. Emanuel, I want to ask you about that Regeneron treatment because President Trump, he’s been touting it as, as he has said it, secure. That’s going to be widely, broadly available.
What are the truth in that claim? I mean, just in terms of the fact, if this is approved and we do get this and it enters the next phase, is this something– is this a drug that would be broadly available? What’s the timeline on that?
EZEKIEL EMANUEL: Well, everything in that statement is wrong. It is not a cure. I think even the company has said it’s not a cure. It’s meant to be given to people, and people, again, with low antibody response to the virus. And it seems to shorten the time of having symptoms. That doesn’t constitute a cure. I don’t believe it’s been tested and evaluated as a cure at all.
Second of all, you know, we’ve got to understand monoclonal– and this drug may be very, very good. We have to understand that monoclonal antibodies are– there’s not enough capacity to produce them. There’s going to be a limited amount available. It’s not going to certainly be– we don’t have enough monoclonal antibodies and can’t even produce enough monoclonal antibodies for the 40, 43,000 people, Americans, who, every day, get infected with this virus.
So the idea that there’s going to be a lot around, we couldn’t treat the number of people, you know, in something, like, 25 days. We have a million people. We can’t produce a million treatments every 25 days. That’s for the United States, not to mention the world. This should not be touted this way. Plus, it’s not going to be a very cheap treatment.
RICK NEWMAN: Hey, Dr. Ezekiel, I want to know if there’s anything anybody can do about this public health problem, where you’ve got people who seem willing to go to Trump rallies and other events like this, knowing that– or they should know, anyway. Some of us know that they’re exposing themselves to higher risk for COVID.
I have some friends in the medical business who say, you know, if people do this, they should sign a waiver and say, fine, I’m going to go to this, but I’m signing away my right to get healthcare and therefore, put health professionals at greater risk than they need to be. I mean, I realize this is a very tough problem when the president himself flouts these guidelines. But is there anything anybody can do about this?
EZEKIEL EMANUEL: Yes, there’s something the president could do about it. I mean, he clearly could do something. And he could say, you know, Joe Biden’s got the right model here. Joe Biden has a model where he wears a mask. He does rallies only where people– with a small number of people, where people are spread out, where every one of the people are actually wearing masks as well.
The president has consciously and repeatedly refused to abide by those guidelines. You know, the only way we’re really going to be able to get our hands around this pandemic is if we actually abide by those public health measures.
And by the way, that’s going to be true, even if we get a vaccine, especially if the vaccine is only 60% or 70% effective. Because we’re still going to have to abide by many of those guidelines until we get enough people vaccinated. And that’s going to take many, many months.
Let me just say, you know, Italy was in the same boat as the United States a few weeks ahead of us in March and April. And then they consciously did a lockdown and really had people adhere to it nationwide. And they brought their rate of new infections very, very low. It’s creaked up a little bit since August, but nowhere near our rate of infection.
It’s not like Italy has a special drug or a vaccine or some other concoction that we don’t. They have one thing, and we have the same thing, which are good, effective public health measures, widely implemented with social pressure for people to adhere to them and backstopped by penalties if people don’t adhere to them. We could do the same.
The president has repeatedly flouted these public health measures, made fun of people who adhere to them. That’s why he got COVID. And, you know, we need a leader who recognizes not that they’ll be cured and everyone could be cured, but in fact, that this is a very deadly disease. About 1,000 people, Americans, a day die from it, and that we can do something to reduce that rate.
SEANA SMITH: Doctor, talking about that rate, when you take a look at the numbers over the past week, more than 44,000 Americans diagnosed with COVID on average each day over the past week. What is that number going to look like as we get into the winter months if the national response to this, if the Trump administration’s response to this does not change?
EZEKIEL EMANUEL: Yeah, it’s scary. It’s going to go up. It’s hard to believe it won’t go up. You know, the four ways this thing– increase the risk of transmission is, enclosed spaces, indoors, large crowds for prolonged period of time with shouting, coughing, sneezing, singing. Going indoors for a prolonged period of time with groups, that is how it’s going to increase the risk of transmission.
And as winter comes in, people do go inside. If they, in fact, go inside with new groups, that is how we’re going to increase the frequency of transmission and increase the number of cases. That’s what has every public health person, including myself, worried about the next few months and the increase in cases, and therefore, the increase in hospitalizations and mortality.
SEANA SMITH: And doctor, going off of that, if we do see this increase in the number of cases, we already have areas in the Northeast and Boston and also in New York City. Certain neighborhoods are reversing course.
They are tightening restrictions on businesses, on schools, on outdoor spaces because of the uptick that we’re seeing in the number of cases. Do you think we should be looking at wider shutdowns at this point? Or at what point should we be possibly reintroducing that?
EZEKIEL EMANUEL: Well, again, the issue is that we need to look at reducing the number of people who crowd, so no more than 20. That looks to be the key number for super spreading events. We need to reduce indoor activities, like having weddings indoors or funerals indoors, dining indoors, bars indoors. Those are dangerous events for spreading.
And I think you don’t want to close down everything. And I think closing down outdoor activities where we can actually spread people out is probably not a great idea. You do need to give people options, but the options have to be safe. So if people are going to be outdoors, they have to be spaced six feet apart. They have to be wearing face masks.
That’s the kind of activity I think we want to encourage, not discourage. But doing indoor activities, that’s, you know, negative. So I’ll tell you again. One of the things I’m doing is, well, we like to dine outside with other people. We’ve got a table where you can be eight feet apart. We’ve got heaters. We’ve got blankets.
You know, we’re planning to do this as long as we possibly can. But those are the kind of things we have to adopt. Dining with other people indoors– not a good idea.
SEANA SMITH: All right, Dr. Ezekiel Emanuel, always great to have you on this show. We look forward to having you back on Yahoo Finance soon. Thanks for taking the time to join us this afternoon.
EZEKIEL EMANUEL: Take care. Have a great weekend, and stay safe, please.